ASSOCIATION OF PRIMARY OPEN ANGLE GLAUCOMA WITH AXIAL MYOPIA

Abstract

TITLE: “ASSOCIATION OF PRIMARY OPEN ANGLE GLAUCOMA WITH AXIAL MYOPIA” Need for the study: In myopia, parallel rays of light comes to a focus in front of the sentient layer of the retina when the eye is at rest. In the great majority of cases, myopia occurs due to elongation of the of the eye, called as axial myopia. 1 Increase in severity of myopia leads to complications and disorders such as primary open angle glaucoma(POAG), myopic tractional maculopathy (MTM), chorioidal neovascularization (CNV) which cause blindness.2,3 Primary open-angle glaucoma is described as a chronic, progressive optic neuropathy that is irreversible with a characteristic acquired loss of optic nerve fibers. 4 It is a multifactorial disorder characterized by open anterior chamber angles, characteristic visual field abnormalities and increase intraocular pressure that can be deleterious to the vision. Often it is seen as a co-morbid condition with axial myopia. However, convincing direct evidences are still remains controversial. If it can be detected in patients with axial myopia at an early stage and early age, treating glaucoma may help the patient to a great extent to avoid irreversible blindness and reduce the blind years of the patient. Thus, the study intended to find out frequency of association between primary open angle glaucoma and POAG suspects with axial myopia. XIII Objectives:  To correlate Axial Myopia with Primary Open Angle Glaucoma and Primary Open Angle Glaucoma Suspects.  To document the correlation between the severity of Axial Myopia and Primary Open Angle Glaucoma and Primary Open Angle Glaucoma Suspects. Methods: This was an observational study, where axial myopes (axial length more than 24.5 mm and spherical equivalence equal to or more than -0.5D) were included and divided into three group as per axial length. Further intraocular pressure (IOP) measurement, gonioscopy, fundus evaluation and visual field analysis was done. Patients were examined and diagnosed as POAG, IOP and Disc suspects. Results: Out of 162 eyes, males consisted of 55.56% (n= 90) and females consisted 44.44 % (n=72) of the study population. 62.9 % (n=102) of the patients were aged between 41 to 50 years and 37.8 % (n=60) belonged to 30-40 years. The average age noted was 43 +5.97 years. 22.22 % (n=26) showed POAG changes, showed an association with axial length (p=0.046). IOP suspects formed 8.64 % (n=14) of the population, showed association with age (p=0.008). Disc suspects formed 27.16 % (n=44) of the population, showed no association with age (p=0.797), gender (p=0.316) and axial length (p=0.070). Conclusion: Our study showed association of axial myopia (aged 41-50 years) with POAG (22.2 %), with male predilection. No such association was found in POAG suspects (36 %). Myopia and glaucoma similar or overlapping optic disc changes and visual fields defects. Our study helps in understanding of this and facilitates the clinician to have a high index of suspicion, leading to early diagnosis and planning XIV appropriate management protocols.